PTSD Prevalence in the Aftermath of Natural Disaster Happened in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

Abstract

Background: Posttraumatic stress disorder (PTSD) is a common and highly invalidating psychological disorder observed in the aftermath of natural disasters. Research has demonstrated that people living in Low and Middle-Income Countries (LMIC) are particularly threatened by PTSD when natural disasters strike. The aim of the current thesis is to ascertain the prevalence of PTSD in the aftermath of natural disasters occurred in LMIC through a systematic review and meta-analysis. Methods: Thirty-eight studies were identified from a systematic search of the PubMed, PsycInfo, Embase and Scopus databases. The combined prevalence of PTSD was estimated by using the Freeman-Tukey double arcsine transformation method and a random-effects model, in addition to 95% confidence intervals, p-values and heterogeneity statistics. Subgroup analyses were conducted using the following variables: gender, bereavement, level of education and time of PTSD assessment. The combined prevalence and heterogeneity statistics were calculated for each population, and a Chi-squared test was performed within each subgroup as to test for significant differences. Results: The combined prevalence of PTSD obtained was 25.68% (95% CI: 20.57- 31.15 %). A high degree of heterogeneity (I-squared = 98.8 %; p < 0.001) was observed. The subgroup analyses showed that PTSD prevalence was significantly higher in women, bereaved individuals and individual assessed within the first year from the occurrence of the natural disaster. Conclusion: The results obtained expand the knowledge about the course of PTSD in LMIC affected by natural disasters. The estimates obtained will hopefully be useful as to inform future research and interventions.